Intracranial epidermoid cyst

Case contributed by Dr Huda B. Gharbia

Presentation

Epilepsy,

Patient Data

Age: 30 years
Gender: Male
MRI

There is a large extra-axial lobulated lesion in right cerebello-pontine angle, insinuating along the basal cisterns extending to perimesencephalic cistern and right temporal region.  This causes significant regional mass effect, compressing and splaying the brainstem (mainly midbrain and pons), shifting it to left side, and displacing the temporal lobe laterally.  It extends to the suprasellar cistern, abutting the ipsilateral cavernous sinus.  The basilar artery is seen in the mid prepontine cistern with normal signal void appearance.

This lesion appears hypointense in T1W and hyperintense in T2W images, heterogenously hypointense in FLAIR sequences, and shows restricted diffusion on DW/ADC.  No enhancement on T1W post contrast.

Case Discussion

Extra-axial cerebellopontine angle cystic lesion, insinuating along basal cistern, appears heterogenous on FLAIR sequences with restricted diffusion but no enhancement, suggestive of epidermoid cyst.

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Case information

rID: 68964
Published: 21st Jun 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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